Ask Dr. Z

Hello: I am hoping you can verify my coding and using code 37201 for Thrombolysis of AV loop graft, total of 15 mg of TPA used in isolated system. I am looking at coding 37201,35476,36147,75896-26 & 75962-26 A small incision was made to expose graft. there was no pulse in the looop graft at all. Access was accomplished through a pursestring and wire was passed up the venous end and then venou end fistulgram was performed showing the vein stopped right at the venous anastomosisi and it appeared that there was some stenosis at the venous anastomosis. Trellis 6 sytems was performed on the venous end for 2 treatments of each 10 cm long. Then Trellis of the arterial end was performed by micro puncture through the skin. Again, an additional 5 mg of TPA for total of 15 and arteriogrm showd fairly good resuts. There was one area in the very proximal end that showed stenosis, this was done with a 6 mm x 4cm balloone at 5 atmospheres of pressure for 3 minutes. Thanks for your assistance!!